Victims Assistance Network

New Account Registration for Treatment Providers

Start by typing the name of the agency you represent in the box below. If you cannot locate your agency, please contact us to update your business profile.

All fields are required unless noted otherwise.

Organization/Agency Represented

FEID Number

Sequence Number (not required)

Street Address

City

State

Zip Code

Title

First Name

Last Name

Direct Phone Number

Fax Number

Date of Birth

Security Question 1:

Answer 1:

Security Question 2:

Answer 2:

Security Question 3:

Answer 3:

Password

Confirm password

Password Requirements:

Minimum of ( 8 ) characters long
Must contain at least one digit
Must contain at least one lowercase letter
Must contain at least one uppercase letter
Must contain at least one special character

Terms and Conditions

By checking this box, I agree to the terms of taking a review to complete my pre-registration. I understand that my information is subject to a validation process which includes verifying my employment with the agency specified above. I acknowledge that my email address serves as my User ID which will systematically purge if I do not sign-in at least once every 30 days. My User ID is non-transferable to any other person or agency. Sharing is prohibited. Improper entries or use of the information obtained from VANext may be unlawful, violate federal, state, and local policies, and may result in prosecution. I agree to eliminate all vulnerabilities that threaten the security or protection of the information. System privileges will be revoked if I fail to utilize the system in accordance with the performance of my job duties in serving crime victims. By accessing the system, I affirm understanding those conditions and thereby enter into an agreement of understanding with the Department of Legal Affairs, Office of the Attorney General, Division of Victim Services and Criminal Justice Programs, Bureau of Victim Compensation.